| NPI | 1205431525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11018492) |
| Additional Taxonomies | 101Y00000X Counselor |
| 163W00000X Registered Nurse (Licence: FL RN9216097) | |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2024-09-03 |